Combined Low-frequency Repetition Transcranial Magnetic Stimulation (rTMS) and Intensive Occupational Therapy for Alien Hand Syndrome after Stroke : A Case Report
10.2490/jjrmc.51.228
- VernacularTitle:脳卒中後Alien hand syndromeに対する低頻度反復性磁気刺激療法と集中的作業療法
- Author:
Takatoshi HARA
;
Kiyohito KAKITA
;
Mami KODAMA
;
Takaaki DOI
;
Masahiro ABO
- Publication Type:Journal Article
- Keywords:
stroke;
repetition transcranial magnetic stimulation;
alien hand syndrome
- From:The Japanese Journal of Rehabilitation Medicine
2014;51(3):228-233
- CountryJapan
- Language:Japanese
-
Abstract:
Alien hand syndrome (AHS) is a rare neurologic disorder in which movements are performed without conscious will. Cognitive rehabilitation is usually first considered for treating AHS. However, we proposed different modalities for the treatment. This is the first case report showing therapeutic effects of the NEURO-15 program that consists of low-frequency repetitive transcranial magnetic stimulation and intensive occupational therapy on AHS symptoms and upper limb dysfunction caused by a stroke one year and three months before. A 68-year-old male developed right upper limb palsy secondary to cerebral infarction on the medial side of the left frontal lobe. On admission, he exhibited disturbed skilled motor behavior, compulsive grasping of the right upper limb, and dissociated behavior of the right hand independent from the left. The right hand interfered with the actions executed by the left hand. The left hand restricted the right hand in its actions by holding it. Six months after the onset, his Activities of Daily Living improved and he was discharged from hospital to home. However, his compulsive grasping of the right upper limb symptoms remained, and he underwent NEURO-15 one year and three months after the onset. His right upper limb function improved. Compulsive grasping of the right upper limb disappeared, and the contradictory action of the right upper limb was rarely seen. These results suggested that NEURO-15 influenced the neural network including the primary motor cortex and supplementary motor area.
